Caprine and ovine brucellosis is caused by the zoonotic bacterium Brucella melitensis. It is considered to be a re-emerging pathogen in the Middle East. In humans, the disease is a serious, debilitating and sometimes chronic disease. It can affect a variety of organs and could be used in a bioterrorist attack.
Caprine and ovine brucellosis is caused by the zoonotic bacterium Brucella melitensis. It is considered to be a re-emerging pathogen in the Middle East. In humans, the disease is a serious, debilitating and sometimes chronic disease. It can affect a variety of organs and could be used in a bioterrorist attack.
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Caprine and ovine brucellosis is caused by the zoonotic bacterium Brucella melitensis. It is considered to be a re-emerging pathogen in the Middle East. In humans, the disease is a serious, debilitating and sometimes chronic disease. It can affect a variety of organs and could be used in a bioterrorist attack.
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Caprine and ovine brucellosis, caused by the zoonotic bacterium Brucella
Brucellosis: melitensis, is an economically important cause of abortion in small ruminants. This infection causes significant losses from decreased productivity and lost trade in much of the developing world. B. melitensis is considered to be a re-emerging pathogen in Brucella melitensis the Middle East. It has been eradicated from some nations, but the cost of surveillance to remain B. melitensis-free is significant. Undulant Fever, Malta Fever, B. melitensis is also an important human pathogen. In humans, brucellosis is a Mediterranean Fever, serious, debilitating and sometimes chronic disease that can affect a variety of organs. Contagious Abortion Most cases are the result of occupational exposure to infected animals, but infections can also occur from ingesting contaminated dairy products. In addition, B. melitensis could be used in a bioterrorist attack. Last Updated: July 29, 2009 Etiology In sheep and goats, brucellosis is mainly caused by Brucella melitensis, a Gram– negative coccobacillus or short rod. This organism is a facultative intracellular pathogen. B. melitensis contains three biovars (biovars 1, 2 and 3). All three biovars cause disease in small ruminants, but their geographic distribution varies. Brucella abortus and Brucella suis infections also occur occasionally in small ruminants, but clinical disease seems to be rare. (For information on B. abortus or B. suis, see the factsheets titled “Bovine Brucellosis” and “Porcine Brucellosis” on the CFSPH webpage at http://www.cfsph.iastate.edu/DiseaseInfo/factsheets.htm) Genetic and immunological evidence suggests that all members of the genus Brucella are closely related, and some microbiologists have proposed that this genus be reclassified into a single species (B. melitensis), which contains many biovars. This proposal is controversial, and both taxonomic systems are currently in use. The multiple species nomenclature is used in this factsheet. Species Affected Most species of Brucella are primarily associated with certain hosts; however, infections can also occur in other species, particularly when they are kept in close contact. Brucella melitensis mainly infects sheep and goats. Most breeds of goats are readily infected, but sheep breeds vary greatly in susceptibility. B. melitensis infections are also been reported occasionally in cattle, camels and dogs, and rarely in horses and pigs. Infections in sheep and goats can spill over into wild ruminants; B. melitensis infections have been reported in alpine ibex in Italy and chamois in the French Alps. However, there is no evidence that these animals serve as reservoir hosts for domesticated sheep and goats. B. melitensis is very contagious to humans. Geographic Distribution B. melitensis is particularly common in the Mediterranean. It also occurs in the Middle East, Central Asia, around the Arabian Gulf, and in some countries of Central America. This organism has been reported from Africa and India, but it does not seem to be endemic in northern Europe, North America (except Mexico), Southeast Asia, Australia, or New Zealand. Biovar 3 is the predominant biovar in the Mediterranean countries and the Middle East, and biovar 1 predominates in Central America. Sporadic cases or incursions are occasionally reported in B. melitensis - free countries. In the U.S., cases have mainly been reported in imported goats and rarely in cattle. Transmission In animals, B. melitensis is usually transmitted by contact with the placenta, fetus, fetal fluids and vaginal discharges from infected animals. Small ruminants are infectious after either abortion or full-term parturition. Goats usually shed B. melitensis in vaginal discharges for at least 2 to 3 months, but shedding usually ends within three weeks in sheep. This organism can also be found in the milk and semen; shedding in milk and semen can be prolonged or lifelong, particularly in goats. Kids and lambs that nurse from infected dams may shed B. melitensis in the feces.
Brucella melitensis Most animals become infected by ingestion or However, abortion, orchitis and epididymitis, and other through the mucous membranes of the oropharynx, upper symptoms of canine brucellosis can also occur. respiratory tract and conjunctiva, but Brucella can also be transmitted through broken skin. Although the mammary Post Mortem Lesions Click to view images gland is usually colonized during the course of an At necropsy, granulomatous inflammatory lesions infection, it can also be infected by direct contact, with may be present in the reproductive tract, udder, subsequent shedding of the organisms in the milk. In supramammary lymph nodes, other lymphoid tissues, and utero infections also occur. Transmission during breeding sometimes in the joints and synovial membranes. is possible, but seems to be uncommon during natural Necrotizing orchitis, epididymitis, seminal vesiculitis and mating. B. melitensis can be spread on fomites, and could prostatitis have been reported. The fetus may be be disseminated mechanically by carnivores that carry autolyzed, normal or have an excess of bloodstained fluid away infected material. In conditions of high humidity, in the body cavities and an enlarged spleen and liver. low temperatures and no sunlight, Brucella can remain Placentitis, with edema and/or necrosis of the cotyledons viable for several months in water, aborted fetuses, and a thickened and leathery intercotyledonary region can manure, wool, hay, equipment and clothes. Brucella be seen. These lesions are not pathognomonic for species can withstand drying, particularly when organic brucellosis. material is present, and can survive in dust and soil. Morbidity and Mortality Survival is longer when the temperature is low, particularly when it is below freezing. B. melitensis is a significant problem in small ruminants, particularly in developing nations where Cattle and other species can be infected with B. infections can be widespread. The relative importance of melitensis after contact with infected sheep and goats. It B. melitensis for sheep and goats varies with the has not been established whether cattle can maintain this geographic region, and can be influenced by husbandry species indefinitely in the absence of contact with small practices and the susceptibility of sheep breeds in the ruminants. Cattle with infected udders can shed B. region. Management practices and environmental melitensis in the milk for months or years. Camels also conditions significantly influence the spread of infection. shed this organism in milk. Humans usually become Lambing or kidding in dark, crowded enclosures favors infected by ingesting organisms (including contaminated, the spread of the organism, while open air parturition in a unpasteurized dairy products) or by the contamination of dry environment results in decreased transmission. mucous membranes and abraded skin. The abortion rate is high when B. melitensis enters a Incubation Period previously unexposed and unvaccinated flock or herd, but The period between infection and abortion or other much lower in flocks where this disease is enzootic. reproductive signs is variable. Ruminants usually abort only during the gestation when they are first infected. Inflammatory changes in infected Clinical Signs mammary glands usually reduce milk yield by a minimum The predominant symptoms in naturally infected of 10%. Fertility in males can be permanently impaired. sheep and goats are abortions, stillbirths and the birth of Deaths are rare except in the fetus. weak offspring. Animals that abort may retain the placenta. Sheep and goats usually abort only once, but Diagnosis reinvasion of the uterus and shedding of organisms can Clinical occur during subsequent pregnancies. Some infected Brucellosis should be considered in flocks and herds animals carry the pregnancy to term, but shed the when abortions and stillbirths occur without concurrent organism. Milk yield is significantly reduced in animals illness. that abort, as well as in animals whose udder becomes infected after a normal birth. However, clinical signs of Differential diagnosis mastitis are uncommon. Other diseases causing abortion in small ruminants, Acute orchitis and epididymitis can occur in males, particularly chlamydiosis and coxiellosis, should be and may result in infertility. Arthritis is seen occasionally considered. B. ovis can also cause epididymitis and in both sexes. Many non-pregnant sheep and goats remain orchitis in rams. asymptomatic. Laboratory tests B. melitensis has also been associated with abortions Microscopic examination of smears stained with the in cattle, and abortions, orchitis and epididymitis in Stamp's modification of the Ziehl-Neelsen method can be camels. In wild chamois, this organism has been linked to useful for a presumptive diagnosis, particularly if the epididymo-orchitis, polyarthritis, blindness and direct examination is supported by serology. Brucella neurological signs, but abortion was not reported. In dogs, species are not truly acid-fast, but they are resistant to infection with B. melitensis is often asymptomatic, and decolorization by weak acids, and stain red against a blue rapid elimination of this organism has been reported. background. Brucellae are coccobacilli or short rods,
Brucella melitensis usually arranged singly but sometimes in pairs or small Samples to collect groups. This test is not definitive. Other organisms that B. melitensis is highly pathogenic for humans; cause abortions such as Chlamydophila abortus and serum samples should be collected and handled with Coxiella burnetii can resemble Brucella. B. ovis, which all appropriate precautions. Special shipping causes epididymitis and orchitis in rams, can also be requirements may need to be met when sending confused with B. melitensis. Immunostaining is samples for culture. sometimes used to identify Brucella in smears. Milk samples and vaginal swabs are particularly Serology can be used for a presumptive diagnosis of useful for diagnosis in live sheep and goats. B. melitensis brucellosis, or to screen flocks. Serological tests are not can also be cultured from aborted fetuses (stomach completely specific and cannot always distinguish reactions contents, spleen and lung) or the placenta. The spleen, due to B. melitensis from cross-reactions to other bacteria, mammary and genital lymph nodes, udder and late particularly Yersinia enterocolitica O:9. The most pregnant or early post-parturient uterus are the most commonly used serological tests in small ruminants are the reliable samples to collect at necropsy. This organism can buffered Brucella antigen tests (the card and rose bengal also be cultured from semen, the testis or epididymis, and (RB) plate agglutination tests) and the complement fixation arthritis or hygroma fluids. test. Indirect or competitive enzyme-linked immunosorbent assays (ELISAs) are also used. In vaccinated sheep and Recommended actions if brucellosis goats, the native hapten-based gel precipitation tests (gel is suspected diffusion or radial immunodiffusion tests) are sometimes used to distinguish vaccination from infection. Other Notification of authorities serological tests are in development or in use in research B. melitensis is considered exotic to the U.S. and must and other special situations. be reported immediately to state or federal authorities. A brucellin allergic skin test is sometimes used to test Federal: Area Veterinarians in Charge (AVIC): unvaccinated sheep and goats for B. melitensis. This test is www.aphis.usda.gov/animal_health/area_offices.htm performed by injecting the allergen into the lower eyelid. State Veterinarians: A definitive diagnosis can be made if B. melitensis is www.aphis.usda.gov/vs/sregs/official.html cultured from an animal. Brucella spp. can be isolated on a variety of plain media, or selective media such as Farrell's Control medium or Thayer-Martin’s modified medium. Enrichment B. melitensis is most likely to be introduced into a techniques can also be used. Brucella colonies usually herd in an infected animal. Semen could also be a source become visible after two days growth. After four days of of infection. This organism can be eradicated from a herd incubation, the colonies are round and approximately 1-2 by test and slaughter procedures, or by depopulation. In mm in diameter with smooth margins. When the plates are areas where B. melitensis is not endemic, infected herds viewed in daylight through a transparent medium, the are usually quarantined and the animals are euthanized. colonies are translucent and a pale honey color. From Because dogs can be infected, some countries require that above, they are convex and pearly white. Smooth (S) shepherd dogs also be euthanized, or treated with Brucella cultures can dissociate to rough (R) forms, and antibiotics and castrated, when flocks are depopulated. sometimes to mucoid (M) forms. These colonies are much Any area exposed to infected animals and their discharges less transparent and become more granular and dull, or should be thoroughly cleaned and disinfected. Infections sticky and glutinous, respectively. B. melitensis can be in other species are generally prevented by controlling B. identified to the species and biovar level by phage typing melitensis in sheep and goats. and cultural, biochemical and serological characteristics. The B. melitensis Rev1 vaccine is used to control this Genetic techniques can also be used for biotyping. The disease in infected areas. Rev 1 can cause abortions in vaccine strain (B. melitensis strain Rev.1) can be pregnant animals. This vaccine also interferes with distinguished from field strains by its growth characteristics serological tests, particularly when it is injected and sensitivity to antibiotics and other additives. subcutaneously, but conjunctival administration to lambs Animal inoculation is uncommon used for isolation, and kids between the ages of 3 and 6 months minimizes this but occasionally necessary when other techniques fail. problem. To reduce transmission, sheep and goats should Guinea pigs or mice can be used. give birth in an area that can be cleaned and disinfected Polymerase chain reaction (PCR) techniques and between animals. The placenta and other contaminated other genetic techniques (PCR restriction fragment length materials should be removed promptly and destroyed. polymorphism or Southern blotting) are available in some Brucella species are readily killed by most commonly laboratories. available disinfectants including hypochlorite solutions, 70% ethanol, isopropanol, iodophores, phenolic disinfectants, formaldehyde, glutaraldehyde and xylene; however, organic matter and low temperatures decrease the efficacy of disinfectants. Disinfectants reported to
Brucella melitensis destroy Brucella on contaminated surfaces include 2.5% Internet Resources sodium hypochlorite, 2-3% caustic soda, 20% freshly slaked lime suspension, or 2% formaldehyde solution (all European Commission. Brucellosis in Sheep and Goats tested for one hour). Ethanol, isopropanol, iodophores, (Brucella melitensis). substituted phenols or diluted hypochlorite solutions can http://europa.eu.int/comm/food/fs/sc/scah/out59_en.pdf be used on contaminated skin. Alkyl quaternary Centers for Disease Control and Prevention (CDC). ammonium compounds are not recommended for this Brucellosis. purpose. Autoclaving [moist heat of 121°C (250°F) for at http://www.cdc.gov/ncidod/dbmd/diseaseinfo/brucellosis_t least 15 minutes] can be used to destroy Brucella species .htm on contaminated equipment. These organisms can also be Food and Agriculture Organization of the United Nations. inactivated by dry heat [160-170°C (320-328°F) for at Manual for the Recognition of Exotic Diseases of least 1 hour]. Boiling for 10 minutes is usually effective Livestock, A Reference Guide for Animal Health Staff. for liquids. Xylene (1ml/liter) and calcium cyanamide (20 http://www.spc.int/rahs/ kg/m3) are reported to decontaminate liquid manure after Public Health Agency of Canada. Material Safety 2 to 4 weeks. Brucella species can also be inactivated by Data Sheets gamma irradiation (e.g. in colostrum) and pasteurization. http://www.phac-aspc.gc.ca/msds-ftss/index.html Their persistence in unpasteurized cheese is influenced by the type of fermentation and ripening time. The The Merck Manual fermentation time necessary to ensure safety in ripened, http://www.merck.com/pubs/mmanual/ fermented cheeses in unknown, but is estimated to be The Merck Veterinary Manual approximately three months. Brucella survives for very http://www.merckvetmanual.com/mvm/index.jsp short periods in meat, unless it is frozen; in frozen meat, World Organization for Animal Health (OIE) survival times of years have been reported. http://www.oie.int OIE Manual of Diagnostic Tests and Vaccines for Public Health Terrestrial Animals B. melitensis is highly pathogenic for humans; this http://www.oie.int/eng/normes/mmanual/a_summry.htm organism is considered to be the most severe human pathogen in the genus. Occupational exposure is seen in laboratory workers, farmers, veterinarians and others who References contact infected animals or tissues. Brucellosis is one of Alton GG, Forsyth JRL. Brucella [online]. In Baron S, editor. the most easily acquired laboratory infections. People Medical microbiology. 4th ed. New York: Churchill who do not work with animals or tissues usually become Livingstone; 1996. Available at: infected by ingesting unpasteurized dairy products. The http://www.gsbs.utmb.edu/ Rev-1 B. melitensis vaccine is also pathogenic for humans microbook/ch028.htm. Accessed 4 Jun 2007. and must be handled with caution to avoid accidental Centers for Disease Control and Prevention [CDC]. injection or contamination of mucous membranes or Brucellosis (Brucella melitensis, abortus, suis, and abraded skin. canis). CDC; 2005 Oct. Available at: Asymptomatic infections can occur in humans. In http://www.cdc.gov/ symptomatic cases, the disease is extremely variable and ncidod/dbmd/diseaseinfo/brucellosis_t.htm. Accessed 4 the clinical signs may appear insidiously or abruptly. Jun 2007. Typically, brucellosis begins as an acute febrile illness with Cutler SJ, Whatmore AM, Commander NJ. Brucellosis--new nonspecific flu-like signs such as fever, headache, malaise, aspects of an old disease. J Appl Microbiol. back pain, myalgia and generalized aches. Drenching 2005;98:1270-1281. sweats can occur, particularly at night. Some patients recover spontaneously, while others develop persistent European Commission [EC]. Health and Consumer symptoms that typically wax and wane. Occasionally seen Protection Directorate General. Brucellosis in sheep and complications include arthritis, spondylitis, chronic fatigue, goats (Brucella melitensis). Report of the Scientific and epididymo-orchitis. Neurologic signs (including Committee on Animal Health and Animal Welfare. EC; personality changes, meningitis, uveitis and optic neuritis), 2001 Jul. Available at: anemia, internal abscesses, nephritis, endocarditis and http://europa.eu.int/comm/food/fs/sc/ dermatitis can also occur. Other organs and tissues can also scah/out59_en.pdf. Accessed 4 Jun 2007. be affected, resulting in a wide variety of syndromes. Treatment is with antibiotics; however, relapses can be seen months after the initial symptoms, even in successfully treated cases. The mortality rate is low; in untreated persons, estimates of the case fatality rate vary from less than 2% to 5%. Deaths are usually caused by endocarditis or meningitis.
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